Limb salvage by percutaneous transluminal recanalization of the occluded superficial femoral artery.

ABSTRACT

Six patients with rest pain and gangrene or ulceration were treated by percutaneous transluminal angioplasty using the Grüntzig balloon catheter. All had superficial femoral artery occlusion with severe stenosis or occlusion of the popliteal and tibial arteries. Two patients had previous distal bypass procedures which had failed, and none was a candidate for arterial reconstruction. The superficial femoral artery was recanalized in five patients with an increase in the above-knee pressure index from 0.5 +/- 0.1 to 1.0 +/- 0.1 (P less than 0.001) and ankle pressure index from 0.2 +/- 0.1 to 0.5 +/- 0.1 (P less than 0.001). All five patients avoided early amputation and were able to ambulate when discharged. The sixth patient could not be recanalized and required above-knee amputation. Restenosis of the recanalized superficial femoral artery occurred in four patients 2 to 5 months later, and repeat transluminal angioplasty was successful in three patients. Two patients have required below-knee amputation 4 and 5 months after recanalization. Transluminal angioplasty can extend our capability of early limb salvage.